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Metformin: Used selectively for its potential to reduce insulin resistance, cycling around periods of intense exercise

Data availability statement The anonymized database is available on demand

Although this disorder is far less common than G6PD deficiency, the vast majority of patients with G6PD deficiency never suffer a hemolytic episode, while PK deficiency has a high penetrance, although also a highly variable phenotype

Safety in human therapeutic contexts is not established, and the compound is not FDA-approved

Long-term use of metformin (for type 2 diabetes) or proton pump inhibitors can also deplete B12 levels over time